Provider Demographics
NPI:1528172350
Name:BRETT, MARY ADAMS (CRNP)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:ADAMS
Last Name:BRETT
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 TOWNE SQUARE DR STE 301
Mailing Address - Street 2:
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-9440
Mailing Address - Country:US
Mailing Address - Phone:717-988-8320
Mailing Address - Fax:717-221-5397
Practice Address - Street 1:121 TOWNE SQUARE DR STE 301
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-9440
Practice Address - Country:US
Practice Address - Phone:717-988-8320
Practice Address - Fax:717-221-5397
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP006359B363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014411440006Medicaid
PA1031553790001Medicaid
PA1031553790001Medicaid